某院2008～2012年儿科血培养病原菌变迁及耐药谱分析

目的：了解近年来儿童血流性感染的病原体构成变化和药敏情况，以指导临床治疗。方法回顾性分析中山大学附属第一医院2008年1月至2012年12月从儿童血液标本中培养出的病原体资料，用WHONET5．6软件分析病原体的构成情况及其药敏情况。结果共培养出病原菌312株，革兰阳性菌122株；革兰阴性菌190株，其中肺炎克雷伯菌比例最大（25．96％）。所有血培养阳性标本主要来自儿科血液病区患者，占51．60％。革兰阳性菌主要对万古霉素、替考拉宁、利奈唑胺敏感，而革兰阴性菌对碳青霉烯类抗菌药物敏感，对常用抗菌药物如氨苄西林、头孢菌素等存在广泛的耐药。结论该院儿科血流性感染的病原体构成以革兰阴性菌占优势，致病细菌对青霉素类及头孢类抗菌药物存在较高耐药性，临床上应合理应用抗菌药物，根据药敏结果选择药物，减少耐药的出现。

The analysis of distribution and sensitivity of etiology of blood infection in pediatric patients from 2008 to 2012

Objective To investigate the distribution of pathogenic bacteria isolated from blood culture of pedi-atric patients and observe the antibiotic sensitivity of these bacteria so as to provide the reference for clinical antimi-crobial usage .Methods The results of drug susceptibility and distribution of pathogens isolated from blood culture of children from January 2008 to December 2012 were analyzed .The antimicrobial susceptibility rates and pathogens dis-tribution were analyzed by WHONET 5 .6 software .Results Three hundred and twelve strains of pathogens were i-solated ,and the main pathogenic bacteria included 122 strains of Gram positive bacteria and 190 strains of Gram nega-tive bacteria ,most of which was Klebsiella pneumoniae with the percentage of 25 .96% .Noteworthily ,51 .60% of the positive blood curltures were from paediatric patients with hematopathy .Most of Gram positive bacteria were sensi-tive to Vancomycin ,Tiecoplanin and Linezolid ,while most of Gram negative bacillus were sensitive to Carbopenem antibiotics and resistant to most of other antibiotics such as Ampicillin and the cephalosporin antibiotics .Conclusion Most of bacteria isolated from children with bloodstream infection were Gram negative bacteria .Pathogens were high-ly resistant to common antibiotics such as Penicillin antibiotics and cephalosporin .It night be important to use antibi-otics rationally and according to drug sensitivity test to use antibiotics so as to reduce the occurrence of bacterial re-sistance .